Jen M Reichenbach Self, PHD LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60171267 Issued in WA

Practice address

8856 13TH Ave SW
Seattle, WA 98106-2439

Phone

(206) 949-8921

NPI assigned

Jan 30, 2017

Last updated

Jan 30, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Marie Self Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1942747878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8856 13TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981062439",
            "telephone_number": "206-949-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8856 13TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981062439",
            "telephone_number": "206-949-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "JEN",
        "middle_name": "M REICHENBACH",
        "name_prefix": "Dr.",
        "credential": "PHD LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60171267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SELF",
            "middle_name": "MARIE",
            "credential": "PHD LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shari Selesky, PA-C
• Olga Selevchuk
• Self and Other PLLC
• Self Space, PLLC
• David D Self, DPT
• Gerald M Seligman, M.D.
• Dalia Selim
• Hazem Selim, MD
• Selinda Care PLLC
• Alex Selinsky, D.C.

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.